🧬 Progression on a CDK4/6 inhibitor does not always mean the pathway is exhausted.
@OncoAlert
At #ESMO26, the final OS analysis of postMONARCH tested abemaciclib + fulvestrant after progression on prior CDK4/6i + endocrine therapy in HR+/HER2– advanced #BreastCancer.
📊 n=368
➡️ Median OS: 32.1 vs 24.6 months
HR 0.80 (0.60–1.06), p=0.1145
➡️ Updated PFS: HR 0.78 (0.62–0.99)
➡️ No new safety signals
The OS difference is numerically meaningful, but not statistically significant.
🎯 Why this matters: continuing CDK4/6 pathway suppression after progression may still have value — but not for every patient, and not with the same magnitude of benefit.
For me, the real next step is to understand who remains biologically CDK-dependent after progression and who should instead switch to a different therapeutic pathway.
That is the precision question behind postMONARCH.
Excellent work from @KalinskyKevin @BianchiniGP @ErikaHamilton9 @DrSGraff @drsarahsam @MuozMateu and the investigators.
Pinging @matteolambe @aftimosp @E_de_Azambuja @hoperugo @stolaney1 @kevinpunie @ElisaAgostinett @GaiaGriguolo @JankovicK @LoiSher
#OncoAlert #ESMO26 #BreastCancer #CDK46 #EndocrineTherapy #PrecisionOncology
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Overall survival from the phase 3 postMONARCH trial of abemaciclib + fulvestrant vs placebo + fulvestrant for HR+, HER2- advanced breast cancer following progression on a prior CDK4/6 inhibitor + endocrine therapy
https://esmocongress.esmo.orgOncoAlert 4Sight Abstracts to be Presented at #ESMO26 1RO: Final Overall Survival Analysis of postMONARCH: Abemaciclib Plus Fulvestrant After Progression on Prior CDK4/6 Inhibitor in HR+, HER2– Advanced Breast Cancer @KalinskyKevin @BianchiniGP @ErikaHamilton9 @DrSGraff @drsarahsam @MuozMateu 🔬 Phase 3, double-blind trial (n=368): abemaciclib or placebo plus fulvestrant in HR+, HER2– ABC after progression on prior CDK4/6i + ET. Final OS analysis. ➡️ Median OS 32.1 vs 24.6 mo; HR 0.80 (0.60–1.06); p=0.1145, statistical significance not reached ➡️ Updated PFS HR 0.78 (0.62–0.99); nominal p=0.0390 ➡️ Safety consistent with the established abemaciclib profile; no new signals ✅ Numerically longer median OS, not statistically significant. While absolute PFS benefit was modest, overall evidence supports considering abemaciclib-based treatment after disease progression on prior CDK4/6i + ET. #BreastCancer 🎙️ Kevin Kalinsky 👥 Giampaolo Bianchini · Erika Hamilton · Stephanie Graff · Kyong Hwa Park · Rinath Jeselsohn · Umut Demirci · Miguel Martin · Rachel Layman · Sara Hurvitz · Sarah Sammons · Peter Kaufman · Montserrat Muñoz · Jiun-I Lai · Holly Knoderer · Cynthia Sandoval · Aarti Chawla · Bastien Nguyen · Yanhong Zhou · Elizabeth Ravenberg · Lacey Litchfield · Lillian Smyth · Seth Wander (4Sight Made from Abstracts publicly available at the ESMO website) Pinging OncoAlert Breast Cancer Faculty @matteolambe @aftimosp @E_de_Azambuja @DrSGraff @ErikaHamilton9 @hoperugo @stolaney1 @BianchiniGP @aftimosp @kevinpunie @ElisaAgostinett @to_be_elizabeth @GaiaGriguolo @JankovicK @raalbany @JavierCortesMD @JaniceTNBCmets @Prof_Nadia_H @LoiSher @jamecancerdoc @Lucarecco @Dr_Oncologista在 X 查看被引用的帖子
来源：Dra. María Natalia Gandur Quiroga · x.com